While the rest of the world tries to restrict opioid access amid a global overdose crisis, New Zealand has quietly introduced regulations making it easier to get more of the pain drugs.

The legal change could now be reversed, after alarmed doctors and pharmacists say it's 'inappropriate and dangerous” and could increase drug dependence and black market sales.

Opioid drugs contributed to 333 Kiwi overdose deaths from 2017-2021, according to NZ Drug Foundation.

But a November amendment to the Misuse of Drugs Regulations authorised prescriptions for three months instead of one, with up to a month's worth doled out at a time. That would allow patients to pick up three times as many pills as Pharmac's current 10-day limit.

Doctors and pharmacists say they only heard about the change when Pharmac proposed aligning its funding schedule with the new rules.

That triggered such an avalanche of opposition that the Health Ministry is now scrambling to stall the prescribing change.

Submissions obtained under The Official Information Act show the College of GPs, NZ Pain Society and Faculty of Pain Medicine jointly wrote to then health minister Andrew Little, warning longer prescriptions increased the risk of drug diversion (sharing or selling), unintended harm and addiction.

The College of GPs said the regulation change was approved without adequate consultation or risk assessment. The college is 'strongly opposed”, especially for non-cancer pain.

Three-month prescribing is 'inappropriate, and dangerous” and restrictions should be tightened, not relaxed, then college medical director Bryan Betty wrote.

'Some specialist GPs are under extraordinary pressure by some patients to prescribe and feel threatened, loosening the rules may result in confusion and greater acquiesce to patient demand.”

Northern Region addiction medicine specialist Alistair Dunn is 'rather alarmed” at the change, and feared 'a Pandora's box will be opened”.

The only rationale for long-term opioid prescribing in the community was for non-cancer, chronic pain, such as back pain, and that was not supported by evidence, Dunn writes. The theft or loss of a whole month's supply also risked 'large, very lethal amounts of opiates going astray”.

Clinical Advisory Pharmacists Association chairperson Penny Clark submits that three-month prescriptions could be 'a slippery slope to dependence”.

Pharmacists also warn they did not have enough safe storage for three times as many controlled drugs, and the increased stocks will make both them and patients a burglary target.

Some submitters support the access change for cancer and palliative care patients.

The strength of opposition prompted the Health Ministry to ask Pharmac not to change its funding rules, so the old prescribing restrictions remain for funded opioids.

The Ministry is now consulting on options, including a regulation u-turn.

Betty, who is now chairman of GPNZ, wants the legal change reversed, and an explanation of how it was ever passed.

'We need to know why it occurred, so it doesn't happen again.

'Our preference would be for it to stay the way it was, for non-cancer pain. We cannot allow the use of opioids to run away.”

A Health Ministry spokesperson says the regulations were amended on the advice of mental health specialists, to improve patient access to some medicines.

Following the concerns raised about opioid prescribing, a cross-agency group reviewed those access controls and identified 'priority areas” for improvement. That included further regulation amendments.

While the ministry sought advice 'from a range of people” on the original amendments, they acknowledged 'not everyone felt they were adequately consulted”.

-Nikki MacDonald/Stuff.